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In the various roles he has undertaken through the years, Val J. Halamandaris has been a singular driving force behind the policy and program initiatives resulting in the recognition of home health care as a viable alternative to institutionalization. His dedication to consumer advocacy, which enhances the quality of life and dignity of those receiving home health care, merits VNA HealthCare Group’s highest recognition and deepest respect. 

VNA HealthCare Group

I have the highest respect for them, especially for the nurses, aides and therapists, who devote their lives to caring for people with disabilities, the infirm and dying Americans.  There are few more noble professions.

President Barack Obama

Home health care agencies do such a wonderful job in this country helping people to be able to remain at home and allowing them to receive services

U.S. Senator Debbie Stabenow (D-MI) Chair, Democratic Steering and Outreach Committee

Home care is a combination of compassion and efficiency.  It is less expensive than institutional care...but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human’s a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals or other institutions

Former Speaker of the U.S. House of Representatives Newt Gingrich (R-GA)

Medicaid covers long-term care, but only for low-income families.  And Medicare only pays for care that is connected to a hospital discharge....our health care system must cover these vital services...[and] we should promote home-based care, which most people prefer, instead of the institutional care that we emphasize now.

Former U.S. Senator Majority Leader Tom Daschle (D-CD)

We need incentives to...keep people in home health care settings...It’s dramatically less expensive than long term care.

U.S. Senator John McCain (R-AZ)


Home care is clearly the wave of the future. It’s clearly where patients want to be cared for. I come from an ethnic family and when a member of our family is severely ill, we would never consider taking them to get institutional care. That’s true of many families for both cultural and financial reasons. If patients have a choice of where they want to be cared for, where it’s done the right way, they choose home.

Donna Shalala, former Secretary of Health and Human Services

A couple of years ago, I spent a little bit of time with the National Association for Home Care & Hospice and its president, Val J. Halamandaris, and I was just blown away. What impressed me so much was that they talked about what they do as opposed to just the strategies of how to deal with Washington or Sacramento or Albany or whatever the case may be. Val is a fanatic about care, and it comes through in every way known to mankind. It comes through in the speakers he invites to their events; it comes through in all the stuff he shares.

Tom Peters, author of In Search of Excellence

Val’s home care organization brings thousands of caregivers together into a dynamic organization that provides them with valuable resources and tools to be even better in their important work. He helps them build self-esteem, which leads to self-motivation.

Mike Vance, former Dean of Disney and author of Think Out of the Box

Val is one of the greatest advocates for seniors in America. He goes beyond the call of duty every time.

Arthur S. Flemming, former Secretary of Health, Education, and Welfare

Val has brought the problems, the challenges, and the opportunities out in the open for everyone to look at. He is a visionary pointing the direction for us. 

Margaret (Peg) Cushman, Professor of Nursing and former President of the Visiting Nurses Association

Although Val has chosen to stay in the background, he deserves much of the credit for what was accomplished both at the U.S. Senate Special Committee on Aging, where he was closely associated with me and at the House Select Committee on Aging, where he was Congressman Claude Pepper’s senior counsel and closest advisor. He put together more hearings on the subject of aging, wrote more reports, drafted more bills, and had more influence on the direction of events than anyone before him or since.

Frank E. Moss, former U.S. Senator

Val’s most important contribution is pulling together all elements of home health care and being able to organize and energize the people involved in the industry.

Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

Kathleen Gardner Cravedi, former Staff Director of the House Select Committee on Aging

Without your untiring support and active participation, the voices of people advocating meaningful and compassionate health care reform may not have been heard by national leaders.

Michael Sullivan, Former Executive Director, Indiana Association for Home Care

All of us have been members of many organizations and NAHC is simply the best there is. NAHC aspires to excellence in every respect; its staff has been repeatedly honored as the best in Washington; the organization lives by the highest values and has demonstrated a passionate interest in the well-being of patients and providers.

Elaine Stephens, Director of Home Care of Steward Home Care/Steward Health Systems and former NAHC C

Home care increasingly is one of the basic building blocks in the developing system of long-term care.  On both economic and recuperative bases, home health care will continue to grow as an essential service for individuals, for families and for the community as a whole.

Former U.S. Senator Olympia Snowe (R-ME)

NCOA is excited to be part of this great event and honored to have such influential award winners in the field of aging.

National Council of Aging

Health care at home…is something we need more of, not less of.  Let us make a commitment to preventive and long-term care.  Let us encourage home care as an alternative to nursing homes and give folks a little help to have their parents there.

Former President Bill Clinton


Making Andrew Carnegie Proud

By Robert Leech

Many proprietary home health agencies are owned by amazing entrepreneurs. Those entrepreneurs who are willing to take risks and start new businesses are indispensable drivers in our economy. At one time or another, every great company was a start-up fueled by the dreams of a daring entrepreneur. Over the past few decades these innovators have created jobs and made vital contributions to our health care delivery system.

One entrepreneur who could really deliver results was the great Andrew Carnegie. He had a fascinating life and offered many bits of advice, including this one: “Concentrate your energies, your thoughts, and your capital. The wise man puts all his eggs in one basket and watches that basket.” Sounds odd because we have all heard it said a thousand times that we should not put all of our eggs in one basket.

But perhaps the standard advice doesn’t apply to highly skilled entrepreneurs who are passionate about watching their baskets. In the years I have worked in home health I have been fortunate to know many entrepreneurs like this. I consider them great friends and great business partners in facing the challenges ahead.

Today’s home health environment is tough. Competition is as rugged as it has ever been. Medicare requirements are more stringent than ever. Margins are rapidly thinning. Recruitment is difficult, and no agency or owner can do it all. While there is a pressing need to be proficient and vigilant on every front, the one aspect of the business that should top the priority list is patient satisfaction. Great companies know that customer service and product quality can never be compromised. Great service builds loyalty. Great service builds great companies. If you need to put all of your eggs in one basket, make it the customer service basket.

One of the best concepts that CMS has created for the home health industry is the Home Health Care Consumer Assessment of Healthcare Providers and Systems Survey (HH-CAHPS) requirement. HH-CAHPS has provided home health agencies with an opportunity to take a fresh approach to customer service and patient satisfaction. Smart agencies realize that patient satisfaction is about more than just a number. It is about a satisfied patient who  received a valued service from the employees of a home health organization and was pleased with the results. HH-CAHPS offers home health entrepreneurs the opportunity to excel in an area that counts. If the owner of a local agency provided the very best home health service in the community and could unquestionably prove that with comparative scores, that owner could corner the market.

In spite of all the challenges we have as home health providers, leading the market in patient satisfaction would be a story that could be told over and over to case managers, physicians, families, insurance companies and ACOs. It is a compelling argument that truly one home health agency is better than the others. The agency that leads in that aspect of the business could easily prove they lead in other key areas as well.

Quality is sometimes an elusive factor to measure. However, there is nothing elusive about publicly reported patient satisfaction scores. They are the strongest and most objective measure of quality we have. They are also so fundamental that everyone can understand them without further explanation.

Again, it is important to remember that patient satisfaction is not just a matter of dry numbers. A satisfied patient is a happy customer and therefore a healthier patient.  

One of the most powerful global domains in the HH-CAHPS structure is the patient’s recommendation of the agency’s services. Nothing is stronger than word-of-mouth advertising. It is one thing to have a great marketing rep, a great website, and a great strategy; but it is even more powerful to have happy patients who would “definitely recommend” your service to others. While we do not want to discount the other domains, they are largely a compilation of other questions and perceptions. A recommendation is more powerful. Many of us choose a physician, an automobile, or a school for our children based on the recommendations of others. In society we live by the recommendations of those we know and trust. It’s no different for home care.

Acute-care hospitals are covered by the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (H-CAHPS) program. One key domain area of H-CAHPS is “patients who reported that they were given information about what to do during their recovery at home.” Home health agencies that can prove they take good care of patients at home can show hospitals that they can improve a hospital’s scores in this key area and others. Patients’ responses regarding their discharge from the acute-care hospital to the home can be driven by the care they receive from their home health agency. A good agency will ensure a good handoff from hospital to home and that will partly determine the patient’s satisfaction with the hospital care they received. That shows an agency’s value, no matter their size.

One time, I was talking with a good friend who mentioned something about the “mom and pop” home health agency down the street and seemed dismissive of their ability to compete simply because they were a mom and pop agency. I reminded him that the mom and pop agency may be the agency that he could trust most with his own family member and we should never sell a locally owned and operated agency short in terms of its ability to compete on any level, especially service. Mom and pop agencies do a great job because their eggs are all in one basket and that basket is important to mom and pop.

In closing, another great quote from Carnegie: “The first man gets the oyster; the second man gets the shell.” Lead the way in patient satisfaction, and you will never get a shell. Build a home health company that Andrew Carnegie would be proud of.


Robert Leech is vice president for home health at HealthSouth Corporation in Birmingham, AL. He is a former president of the Tennessee Association for Home Care & presently serves as a member of NAHC’s Proprietary Home Care Association of America advisory board. He can be reached at

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